KELLEY ANN SMITH (NPI# 1689165664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689165664 |
| Entity Type | Individual |
| Full Name | KELLEY ANN SMITH |
| Credential | CADC I, CRM |
| Practice Address |
300 W Main St Medford OR 97501-2756 |
| Practice Telephone | 5417721777 |
| Practice Fax Number | 5417342410 |
| Mailing Telephone | 5417721777 |
| Mailing Fax Number | 5417342410 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2020-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
17-07-25 | OR | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346756822 | Kelley Sue Smith | Occupational Therapy Assistant | 24 Highland Ave, Newport, ME 04953-3229 | 2017-12-20 |
| 1093023517 | Kelley Anne Smith | Social Worker | 290 Turnpike Rd Ste 5-138, Westborough, MA 01581-2843 | 2010-09-17 |
| 1508188442 | Kelley Louise Smith | Physical Therapist | 1046 Hummingbird Way, Apt 7, Bloomington, IL 61704-6628 | 2010-02-19 |
| 1962649772 | Kelley Smith | Rehabilitation Practitioner | 1385 N Hamilton Pkwy, Novato, CA 94949-8276 | 2009-01-15 |
| 1407470784 | Kelley Elizabeth Smith | Counselor | 1115 Bethel Rd, Columbus, OH 43220-2690 | 2020-06-03 |
| 1619472685 | Kelley Smith | Student in an Organized Health Care Education/Training Program | 800 Rose St Rm H110, Lexington, KY 40536-7001 | 2018-03-29 |
| 1366874471 | Kelley Elizabeth Smith | Emergency Medicine | 1735 27th St, Waller Bldg. Suite B 06, Portsmouth, OH 45662-2677 | 2013-07-31 |
| 1235477894 | Kelley N Smith | Nurse Practitioner | 200 N Highway 25, Travelers Rest, SC 29690-2300 | 2013-01-16 |
| 1538417688 | Kelley Suzanne Smith | Nurse Practitioner | 520 Douglas Blvd, Tyler, TX 75702-8307 | 2012-08-21 |
| 1174893051 | Kelley Smith | Pharmacist | 4720 Nine Mile Rd, Richmond, VA 23223-4943 | 2012-01-09 |
| Street Address |
300 W MAIN ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568074698 | Jocksana Paulina Corona | Counselor | 300 W Main St, Medford, OR 97501-2756 | 2020-08-19 |
| 1447887468 | Jacqueline Kennedy | Technician, Health Information | 300 W Main St, Medford, OR 97501-2756 | 2020-03-27 |
| 1003453168 | Brenda Palomera | Technician, Health Information | 300 W Main St, Medford, OR 97501-2756 | 2019-12-06 |
| 1326681909 | Melisa Ann Bond | Counselor | 300 W Main St, Medford, OR 97501-2756 | 2019-10-25 |
| 1770125395 | Jessica Ann Schlueter | Counselor | 300 W Main St, Medford, OR 97501-2756 | 2019-10-15 |
| 1952943029 | Winslow Cervantes | Peer Specialist | 300 W Main St, Medford, OR 97501-2756 | 2019-10-10 |
| 1245881168 | Danielle Cassidy Stanford | Technician, Health Information | 300 W Main St, Medford, OR 97501-2756 | 2019-09-23 |
| 1134775034 | Courtney Lynn Alvarenga | Behavior Technician | 300 W Main St, Medford, OR 97501-2756 | 2019-08-15 |
| 1457911430 | Sasha Christophersen | Counselor | 300 W Main St, Medford, OR 97501-2756 | 2019-06-20 |
| 1124686167 | Yesica Bustos-moran | Spec/Tech, Health Info | 300 W Main St, Medford, OR 97501-2756 | 2019-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124685870 | Tracy L Sunde | Counselor | 512 4th St Sw, Medford, MN 55049-9568 | 2019-05-28 |
| 1245737956 | Larkspur Counseling LLC | Counselor | 328 S Central Ave Ste 212, Medford, OR 97501-7274 | 2018-04-09 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1255875654 | Danielle E Peterson | Counselor | 429 W Broadway Ave, Medford, WI 54451-1608 | 2016-12-05 |
| 1376099523 | Patricia Mcatee | Counselor | 243 N Holly St, Apt 1, Medford, OR 97501-5603 | 2016-08-28 |
| 1437512449 | Sage Bosch | Counselor | 1003 E Main St # 104, Medford, OR 97504-7448 | 2016-03-29 |
| 1114385853 | April Collins-macauley | Counselor | 234 W 5th St, Medford, OR 97501-2611 | 2016-02-09 |
| 1154714418 | Marykay Powell | Counselor | 4175 Cedar Ln, Medford, OR 97501-9611 | 2015-03-11 |
| 1699163931 | Violeta Iguchi | Counselor | 3501 Excel Dr Ste 225, Medford, OR 97504-8067 | 2015-01-08 |
| 1790109049 | Ellen Lynch | Counselor | 3251 Route 112 Ste 2, Medford, NY 11763-1446 | 2014-02-06 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.